The Bald Truth About Hair Loss In Young Men

By | February 18, 2014

hlymAs a young boy, Marty Noble’s brownish, thinning hair sprouted unruly cowlicks. Then, no sooner had he made peace with his wispy locks than he began to lose them. Strand by strand his hair got thinner. It began to fall out, in the front and on the crown. Noble was just 18.

I was upset. I used to cry. It was horrible,” recalls Noble, now 27 and a buff Philadelphia masseur. “When you are a teen, your looks are the first thing that other teens judge you on. Your hair is part of your appearance. I couldn’t get the hairstyles that were cool.”

If you’re between 18 and 40 and your comb or brush sports more hair than your head, take heart. Many young men — Noble included — feel your pain. Yes, Michael Jordan, Andre Agassi and a slew of other famous and not-so-famous men sport cleanly shaven, fashionably shiny pates these days. But, if the popularity of such hair-growing drugs as Rogaine and Propecia is any indication, most men — even young balding ones — aren’t ready for the Charles Barkley look.

“There is a societal pressure to have a full head of hair. Many studies show that there are psychosocial ramifications when one has hair loss,” says Amy McMichael, M.D., associate professor of dermatology at the Wake Forest University School of Medicine and a fellow of the American Academy of Dermatology.

The reason has to do as much with a young man’s perception of his own well-being as with his self-esteem or vanity. It also has to do with stereotyping — a young man with a mop of hair is often seen as fitter, more attractive and desirable than one whose hair is going or gone, Dr. McMichael says.

Little wonder why a young man begins to obsess so over each precious strand of hair that, quite literally, is swept down the drain.

“Certainly, hair is looked at as a measure of health, a measure of success and youth in our society,” Dr. McMichael says.

The Cycle Of Typical Hair Loss

The perennial shedding of some hair is part of the natural hair-growth cycle throughout an individual’s life.
“If you have no hair coming out you are probably not alive,” Dr. McMichael says. “In terms of scalp hair, normal hair loss is about 50 to 100 hairs a day,” she says.

These hairs are automatically replaced by the growth of new hairs. Experts say that at any given time 90 percent of your hair is growing and 10 percent is resting.

“That’s where the 50 to 100 hairs a day — the normal hair loss — comes from,” Dr. McMichael says.

The Gene Connection

So why does the hair on some guys’ heads begin to shorten, become thin and drop out, never to grow back again?
The most likely cause of this mostly aesthetic problem is something young men have no control over: male-pattern baldness, the same phenomenon that strikes men twice Noble’s age. It is by far the most common type of hair loss in men 18 to 40 years of age.

According to the American Academy of Dermatology, male-pattern baldness affects nearly 50 million men in the United States. About 20 percent of white men in the United States begin to experience this condition by age 20, and the incidence increases about 10 percent each decade. By age 50, half these men will have some male-pattern hair loss, says Dr. McMichael. Comparable research is lacking for blacks, Hispanics and other racial groups.

The medical name for male-pattern baldness is androgenetic alopecia. You also might hear it called hereditary-pattern baldness. That’s because women as well as men can carry the genetic marker that precipitates it. In men, however, the condition is usually called male-pattern baldness because the pattern of hair loss (most often affecting the frontal hairline) differs from the pattern experienced by women (occurring most often on the crown of the head).

Male-pattern baldness develops differently in different men. In some, balding begins directly above the forehead, spreading to the back of the head, leaving a normal amount of hair at the sides and a swath, resembling a dramatic widow’s peak, in the center of the head. Others experience “vertex” hair loss, where significant concentrations of hair fade away on the crown of the scalp. Then there are young men like, like Noble, who have a mixture of both patterns.

“Half of my family is going bald,” Noble says. “I accept it as the family genetics. My father and my grandfathers on both sides of my family were bald by the time they were 30.”

The diagnosis of hereditary pattern baldness relies on medical history, hair-care history and visual inspection. Most people know it when they see it, Dr. McMichael says. “It doesn’t present a diagnostic quandary.”

There can be other reasons why a young man in the prime of life starts to lose significant amounts of hair, particularly if the hair loss is relatively sudden. Some skin disorders and diseases can cause it. Some disorders of the immune system can also lead to hair loss, as can nutritional deficiencies. Side effects of certain medications, such as lithium (used to treat bipolar disorder), or beta-blockers (used to treat certain cardiovascular disorders and migraine headaches) also cause hair loss.

Finally, hair-damaging products and styling practices can also lead to hair loss. The first line of treatment for these types of excessive hair loss is treating the underlying cause.

Bruised Egos, Rogaine And Razors

There are several remedies for male-pattern baldness. Temporary hair-enhancing options include hair weaves, toupees and other hairpieces. Permanent remedies include surgical procedures such as hair transplants, scalp reduction and hair flaps.

Noble has yet to consider such procedures, though some of his balding friends have. A few have even gotten hair transplants. But Noble did have a fling with two popular hair-growth medications.

“I went to my regular doctor and he set me up with Propecia (finasteride) and Rogaine (minoxidil),” Noble says. Results were slow in coming, and “I just didn’t have the patience for it,” he says. “Plus, it was expensive.”
It seems that some balding men with more patience — young and old — are finding relief through Propecia and Rogaine, both approved by the U.S. Food and Drug Administration. Most men using Rogaine will experience a slowing or stopping of hair loss and some will even experience an increase in hair density. Hair loss slows down in 88 percent of users who take Propecia in the pill form, with more than half of them experiencing some hair growth on the crown.

There is, of course, another remedy. It’s quick and cheap, and it’s what Noble decided to do: Go bald.
“I shaved it probably when I was 23-24,” he says.

Three years later he’s still bald. “I’m truly, truly comfortable,” Noble says about his smooth, hairless dome. “I’m comfortable with myself. If you are confident in your abilities, and with whom you are, that’s what counts. Hair [alone] is not going to get you through life.”

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